Is Your Brain Fog From Menopause, Dementia, or ADHD?

Symptoms can be the result of changing hormones or could be an attention deficit disorder.

By Marie Suszynski

Medically Reviewed by Farrokh Sohrabi, MD

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Cognitive issues are very common when going through menopause.

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Attention deficit/hyperactivity disorder, or ADHD, has long been studied, mainly in children, but experts have come to realize it occurs in women more often than previously thought. If you begin having trouble focusing during menopause, you may be wondering whether it’s a result of hormones, dementia, or something else. That something else could be ADHD.

Cognitive issues like brain fog are very common among women going through menopause, says Mary Rosser, MD, PhD, an ob-gyn at the Montefiore Women's Center in Scarsdale, New York.

“This is something that is wide-ranging, but people are worried that they’re developing dementia,” Dr. Rosser says. “They rush to tell us their memory is declining, they can’t concentrate, they’re not as organized, and that they have a lower attention span.”

The good news is that in most cases, it’s not early-stage dementia. The symptoms are more often a normal part of menopause, or a result of undiagnosed ADHD, Rosser says.

ADHD Before and After Menopause

Women struggle the most with memory problems during the first year after their last menstrual period, according to a study published in the journal Menopause in 2013.

Although experts don’t yet know why menopause brings on cognitive problems, it may be in part due to falling estrogen levels. Estrogen works with the areas of the brain that affect verbal memory and executive function, which helps with organizing information, according to the researchers.

In addition, other menopausal symptoms, such as depression, hot flashes, and trouble sleeping, can affect your ability to focus.

But having trouble focusing and paying attention are also the hallmarks of ADHD. It's not just a condition of childhood: About 2.5 percent of adults have ADHD, according to the American Psychiatric Association.

Men have been diagnosed with ADHD twice as often as women, with the majority of the studies being done in men. Researchers now believe many women may have gone undiagnosed, according to an article in Frontiers in Human Neuroscience published in 2014.

Brain fog related to menopause and ADHD brain fog look similar, Rosser says. So how do you know whether what you’re experiencing is menopause or an attention disorder?

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Ask yourself whether you had these symptoms before menopause. If the symptoms are new, they’re probably related to changing hormones, Rosser says. But if you’ve always been this way and it’s gotten worse with menopause, it could be a result of ADHD. “The only way to really know is to see a psychiatrist who is an expert in ADHD,” Rosser adds.

What to Do About Brain Fog

First, remember that menopause is a normal, healthy stage of life, says Nada Stotland, MD, MPH, a past president of the American Psychiatric Association and professor of psychiatry at Rush University in Chicago.

“We have symptoms and some of them can be hot flashes and night sweats that can be disruptive and tiring and draining, but I don’t think anything significant happens to our brains,” Dr. Stotland says. “I think it’s a normal, passing phenomenon.”

In fact, menopause symptoms of brain fog usually get better over time, Rosser says.

If the symptoms are bothersome enough that you want to get treatment and they’re related to menopause, hormone replacement therapy (HRT) can help, she says.

However, women are understandably nervous about HRT because of the potential increased risk of blood clots, stroke, heart attack, and breast cancer, according to the National Institutes of Health.

Other drug options include anti-anxiety drugs and antidepressants. When it comes to lifestyle factors, taking care of yourself by exercising, eating healthily, getting enough sleep, and limiting alcohol and caffeine can also help improve symptoms, Rosser says.

If your symptoms are related to ADHD, keep in mind that many women can benefit from treatment even if they’ve never previously been treated for the disorder.

“If you’ve gotten to menopausal age, unless you’re still having a lot of problems with attention, you can probably go along the same way, but you may feel better now that you recognize it,” Stotland says. Also, while people with ADHD have a hard time concentrating at times, they may also have the ability to focus very deeply at other times, she says.

If you want treatment for ADHD, you can see a psychiatrist, who may recommend a prescription medication. Also, much of the same lifestyle changes that help menopause can also help with ADHD.

Video: All About Brain Fog (or "Menopause Brain")

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